Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis, Missouri.
J Reconstr Microsurg. 2024 Jun;40(5):398-406. doi: 10.1055/a-2199-3870. Epub 2023 Oct 26.
BACKGROUND: Augmented reality (AR) and virtual reality (VR)-termed mixed reality-have shown promise in the care of operative patients. Currently, AR and VR have well-known applications for craniofacial surgery, specifically in preoperative planning. However, the application of AR/VR technology to other reconstructive challenges has not been widely adopted. Thus, the purpose of this investigation is to outline the current applications of AR and VR in the operative setting. METHODS: The literature pertaining to the use of AR/VR technology in the operative setting was examined. Emphasis was placed on the use of mixed reality technology in surgical subspecialities, including plastic surgery, oral and maxillofacial surgery, colorectal surgery, neurosurgery, otolaryngology, neurosurgery, and orthopaedic surgery. RESULTS: Presently, mixed reality is widely used in the care of patients requiring complex reconstruction of the craniomaxillofacial skeleton for pre- and intraoperative planning. For upper extremity amputees, there is evidence that VR may be efficacious in the treatment of phantom limb pain. Furthermore, VR has untapped potential as a cost-effective tool for microsurgical education and for training residents on techniques in surgical and nonsurgical aesthetic treatment. There is utility for mixed reality in breast reconstruction for preoperative planning, mapping perforators, and decreasing operative time. VR has well- documented applications in the planning of deep inferior epigastric perforator flaps by creating three-dimensional immersive simulations based on a patient's preoperative computed tomography angiogram. CONCLUSION: The benefits of AR and VR are numerous for both patients and surgeons. VR has been shown to increase surgical precision and decrease operative time. Furthermore, it is effective for patient-specific rehearsal which uses the patient's exact anatomical data to rehearse the procedure before performing it on the actual patient. Taken together, AR/VR technology can improve patient outcomes, decrease operative times, and lower the burden of care on both patients and health care institutions.
背景:增强现实(AR)和虚拟现实(VR)——被称为混合现实——在手术患者的护理中显示出了潜力。目前,AR 和 VR 在颅面外科手术中具有众所周知的应用,特别是在术前规划中。然而,AR/VR 技术在其他重建挑战中的应用尚未得到广泛采用。因此,本研究旨在概述 AR 和 VR 在手术环境中的当前应用。
方法:检查了与手术环境中使用 AR/VR 技术相关的文献。重点放在混合现实技术在外科亚专科中的应用,包括整形外科、口腔颌面外科、结直肠外科、神经外科、耳鼻喉科、神经外科和矫形外科。
结果:目前,混合现实广泛应用于需要对颅面骨骼进行复杂重建的患者的术前和术中规划。对于上肢截肢者,有证据表明 VR 可能对治疗幻肢痛有效。此外,VR 作为一种具有成本效益的工具,具有未开发的潜力,可用于显微外科教育和培训住院医师进行手术和非手术美容治疗技术。混合现实在乳房重建术前规划、穿支映射和缩短手术时间方面具有实用性。VR 在深部腹壁下穿支皮瓣的规划中有很好的应用,通过基于患者术前计算机断层血管造影创建三维沉浸式模拟。
结论:AR 和 VR 为患者和外科医生带来了众多好处。VR 已被证明可以提高手术精度并缩短手术时间。此外,它对于使用患者的确切解剖数据进行特定于患者的排练非常有效,在对实际患者进行手术之前,可以排练该程序。总之,AR/VR 技术可以改善患者的治疗效果,缩短手术时间,并减轻患者和医疗机构的护理负担。
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